Transient pseudo-precocious puberty by probable oestrogen intake in 3 girls

The Fate of Synthetic and Endogenous Hormones Used in the US Beef and Dairy Industries and the Potential for Human Exposure

PURPOSE OF REVIEW

Growth-enhancing chemicals used by the beef and dairy industries may be bioavailable to humans via milk, meat, and other environmental matrices. This review evaluates the potential for environmental transport and bioavailability of the active chemical to humans.

RECENT FINDINGS

Bovine somatostatin is detectable in milk; however, there is no evidence that the protein persists in the environment nor that it is active in humans. In contrast, steroids are transported through milk and meat to humans where they may exert biological activity. Furthermore, environmental matrices such as raw water and dust may also allow for the environmental transport and bioavailability of steroids to humans. Endogenous and exogenous steroids can be found in the meat, milk, and waste materials produced by cattle. While the concentrations may be low, exposure to these matrices, most notably dairy products made with whole milk, can be a source of exogenous steroids to humans.

Feminizing Sertoli Cell Tumor Associated with Peutz-Jeghers Syndrome (Histologic and ultrastructural study)

A case of Peutz-Jeghers syndrome associated with Sertoli cell tumor of the testis and bilateral gynecomasty in an 8-year-old boy is described. The authors emphasize the unusual histologic and ultrastructural features of the tumor and discuss the physiopathologic aspects of the present case.

Transient central precocious puberty in non-classic 21-hydroxylase deficiency

A seven year-old boy with non-classic 21-hydroxylase deficiency had transient hormonal evidence of central precocious puberty within three months of beginning glucocorticoid treatment for rapidly progressive somatic virilization. Adrenal-derived sex hormones were normalized promptly by hydrocortisone treatment. GnRH-stimulated LH levels and basal testosterone returned to the prepubertal range without further intervention after six months of glucocorticoid therapy. This is the first report of transient central precocious puberty in the mild non-classic form of congenital adrenal hyperplasia due to 21-hydroxylase deficiency.

Diethylstilboestrol--historical background and current regulatory status

Diethylstilboestrol is a non-steroidal orally active oestrogen that in the past has been widely used in a variety of conditions in both medical and veterinary fields. In recognition of potential systemic availability to man of DES in the tissues of treated food-producing animals, together with an understanding of the potential teratogenic and carcinogenic toxicity of DES in man, the veterinary use of DES has been restricted to oral use in small animals only. Use of DES is prohibited in all food-producing animals.

Massive breast enlargement in an infant girl with central nervous system dysfunction

A 6-month-old female is described who presented with severe idiopathic macromastia. The breast enlargement began at 2 months of age and progressed such that subtotal mastectomies were necessary at 23 months. Extensive hormonal evaluation prior to surgery revealed no evidence of estrogenization or precocious puberty. There was no galactorrhea. A breast biopsy showed immature mammary tissue. In vitro analysis of the patient's serum using a mouse mammary thymidine incorporation assay revealed similar mitogenic activity in the patient's serum compared to adult controls. Post surgical follow up of this patient, 3.5 years later, has revealed no breast enlargement, precocious sexual development, or growth acceleration. Of interest, however, she has manifested an idiopathic degenerative neurologic condition characterized by psychomotor delay, ataxia, and seizures. Remarkably, hormone studies at age 5.5 years showed an exaggerated gonadotrophin response to intravenous gonadotrophin releasing hormone and prepubertal estrogen levels. While this case may represent an extraordinary example of idiopathic premature thelarche, the severe nature of this infant's macromastia in association with neurologic dysfunction and increased gonadotrophins suggests that central nervous system factors were etiologic.

Transient true precocious puberty. A report of five cases

Five girls with idiopathic true precocious puberty are reported who underwent spontaneous regression of sexual development. In all patients the signs of sexual maturation were of moderate degree. Considering the possible spontaneous regression of precocious puberty, in similar cases it seems advisable to defer suppressive central therapy for about 6-12 months.